As suggested by its name, pregnancy-associated plasma protein-A (PAPP-A) plays an important role in pregnancy and fetal development (Brizot et al., 1996; Lin et al., 1974; Smith et al., 2002). On the opposite end of life's spectrum, recent studies using genetically-engineered mice indicate a newly recognized role for PAPP-A in aging and in the development of age-related disease. These latter studies will be reviewed in this article.